The CMS Innovation Center unveiled a new demonstration program Tuesday that will allow Medicare Advantage insurers to encourage the use of clinically valuable services by lowering out-of-pocket costs for enrollees.
Medicare Advantage has been held up as a source of solid growth for health insurers. Humana's reach and expertise in the market attracted Aetna's $37 billion buyout bid. But not all Advantage plans are benefiting from the enrollment wave.
Accountable care organizations in Medicare's Shared Savings Program get to decide for themselves how to distribute bonuses, and primary-care doctors appear to be benefiting the most, according to a review of disclosures by the participants.
Over the several years that the CMS and hospitals have been tussling over the reasons behind the steady rise in short-term observation stays, no one until now has suggested the increase represents a deliberate effort by hospitals to avoid Medicare's 30-day readmission penalties.
Just how much success have hospitals had in their efforts to prevent patients from returning soon after leaving? Perhaps not as much as reported, two physicians argue at the blog for health policy journal Health Affairs.
As providers around the country brace for the Oct. 1 conversion to ICD-10 diagnostic and procedural codes, the CMS is reporting positive results from the final round of end-to-end testing of the Medicare claims processing system.
A recent decision by a federal judge may help bolster providers' lawsuits against Medicare Advantage plans over those plans' decisions to slash reimbursement rates in response to federal budget cuts.
Famous people don't often get involved with Medicare payment policy, but a Boston Marathon bombing survivor and a former U.S. senator who lost a leg in wartime service have joined an industry campaign to block new requirements for artificial legs and feet.
Three out of four Medicare accountable care organizations did not slow health spending enough to earn bonuses last year, a continuation of mixed results for an initiative that federal officials have targeted for rapid expansion.
Competition among Medicare Advantage plans more closely resembles local oligopolies instead of a buzzing market overflowing with options for seniors, a new study from the Commonwealth Fund shows.
The latest Kaiser Family Foundation tracking poll showed most Americans are more concerned about the rising price of drugs than repeal of the Affordable Care Act. But drug prices are not the only cost issue on peoples' minds.
Billions of dollars flowing from settlements in mass tort litigation have recently spurred a new twist on a familiar business—medical lending.